MRI guided prostate biopsy

What is an MRI guided prostate biopsy?

MRI guided prostate biopsy is the ability to target and biopsy suspicious regions of the prostate under the guidance of MRI. In a MRI guided prostate biopsy the patient undergoes a prostate biopsy while in the MRI machine. MRI guided prostate biopsy is a short procedure performed in an outpatient setting by a urologist or radiologist. MRI guided prostate biopsy was first introduced at the Wesley Hospital in 2011.

The Wesley Urologists and Radiologists were the first in the world to perform a prospective trial comparing MRI guided prostate biopsy to standard ultrasound guided biopsy with the results published in 2014 in the European Urology Journal.

Prostate MRI offers detailed images for cancer diagnosis

Prostate MRI or Magnetic resonance imaging of the prostate produces clear, detailed images of the structures within a prostate gland better than any other imaging modality. Over the last 5 years prostate MRI has emerged as a revolutionary imaging tool for the diagnosis of prostate cancer. Prostate MRI enables an experienced radiologist to view the extent of prostate cancer and assess whether it has spread. Comprehensive MR imaging of the prostate also plays a major role in the diagnosis of infection, BPH (benign prostate hyperplasia) and congenital abnormalities.

In September 2018 a new study on MRGB was published. This study aimed to review the Wesley Hospital’s experience with MRGB and compare the results to the international medical literature.

The study looked at Imaging and biopsy results of 554 men who underwent a MRGB over a five year period. Within the study 80% of patients (443 men) were positive for prostate cancer, and 55% of patients (307 men) had a significant cancer. The study identified that a key predictor of positive cancer being detected was PI-RADS, (the scoring system a radiologist uses when reviewing prostate MRI images). For example, prostate cancer was found on biopsy of 97% of men who were scored as PI-RADS 5 (the highest score, indicating the radiologist thinks significant cancer is very likely to be present). In comparison, only 36% of men with a PI-RADS score of 3 (intermediate likelihood of significant cancer) were confirmed to have prostate cancer.

The study demonstrated the value of a two-step approach to diagnosing prostate cancer. Prostate MRI (with PI-RADS scoring) followed by MRGB if the MRI is suspicious for cancer as per the PI-RADS score assigned by the Radiologist.

Wesley Medical Imaging has been recognised by Radboud University as a Centre of Excellence in Prostate Imaging.